Individuals with vertigo incorrectly perceive motion (often a rotating motion) in their environment. Sensations of vertigo can disrupt your balance and contribute to falls that can be dangerous in the elderly; it can also be coupled with dizziness, sensations of spinning in space, and more infrequently, nausea, vomiting, migraine headaches, visual abnormalities such as nystagmus, and fainting.

Vertigo has many underlying causes, but one of them relates to hearingbenign paroxysmal positional vertigo, or BPPV. BPPV arises as the result of calcium crystals that form naturally known as otoconia or otoliths, which usually cause no issues. In BPPV, the crystals travel from their normal locations into the semicircular canals of the inner ear. Once inside the semicircular canals, the crystals trigger an abnormal displacement of endolymph fluid every time a person reorients their head (relative to gravity). This is the root cause of the vertigo sensations in cases of BPPV.

Everyday motions such as looking up and down, tilting your head or rolling over in bed can bring about the BPPV. The vertigo sensation comes on very suddenly and has a short duration. The ensuing vertigo can be made worse by anxiety, sleep disorders, or changes in barometric pressure (for instance, just before a snowfall or rainfall). The disorder can manifest itself at any age, but it most commonly appears in people over 60. The initial trigger for the BPPV is typically hard to determine. An unexpected blow to the head (for example in a car accident) is among the more common causes.

BPPV is differentiated from other forms of vertigo or dizziness in that it is almost always prompted by head movements, and in that its symptoms usually decrease in less than a minute. Health professionals may diagnose it by having the patient lie on their back and then tip their head to one side or over the edge of the examination table. There are more exacting tests which can be used to diagnose BPPV, such as videonystagmography (VNG) or electronystagmography (ENG), which test for abnormal eye movement, or magnetic resonance imaging (MRI), which is used primarily to rule out other possible causes of the vertigo.

There is no complete cure for benign paroxysmal positional vertigo, but it can be successfully treated using canalith repositioning (either the Semont maneuver or the Epley maneuver), both of which use physical movements to guide the crystals to a position in which they no longer cause trouble.In some cases (less than 10 percent), if these therapies don’t provide relief, surgery can be suggested. If you have experienced unexplained vertigo or dizziness that lasts for more than a week, see your doctor.

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